Chapter 10: Immunoglobulin A nephropathy

doi:10.1038/kisup.2012.23

Cited by 103 publications

(23 citation statements)

References 70 publications

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“…However, several previous studies have reported that an initial lower GFR was not accompanied by a faster rate of kidney function decline [ 26 , 27 ]. Thus, in KIDGO 2012, experts commented that, "proteinuria, blood pressure, and pathological features should take precedence over initial GFR in the estimation of the future rate of kidney function decline" [ 2 ]. For this reason, it is important to distinguish those patients whose disease is likely to continuously progress to ESRD, even patients with renal dysfunction at presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Previous large-scale studies reported that 25% of patients will have end-stage renal disease (ESRD) 20 years after diagnosis, and an additional 20% will have progressive impairment of renal function [ 1 ]. According to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline of 2012, proteinuria, blood pressure, and kidney biopsy findings at presentation are associated with risk of ESRD and the doubling of serum creatinine levels [ 2 ]. Among these, proteinuria > 1 g/day is a powerful independent predictor of accelerated renal function decline [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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High serum and urine neutrophil gelatinaseassociated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy

Rhee

Shin

et al. 2015

Korean J Intern Med

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Background/AimsTubulointerstitial injury plays an important role in the progression of immunoglobulin A nephropathy (IgAN), and neutrophil gelatinase-associated lipocalin (NGAL) is among the most sensitive tubular biomarkers. We investigated whether serum or urine NGAL predicts prognosis in patients with IgAN.MethodsThe present study enrolled patients with biopsy-proven IgAN from January 2005 to December 2010, whose serum and urine samples at the time of kidney biopsy were preserved by freezing. We retrospectively reviewed patient clinical data and followed patients until October 2012. Serum and urine NGAL levels were measured using an enzyme-linked immunosorbent assay kit. Renal progression was defined as an estimated glomerular filtration rate decline by > 50% or progression to end-stage renal disease.ResultsThere were 121 patients enrolled in this study. During the median follow-up period of 41.49 months, renal progression was found in nine patients (7.4%). Serum or urine NGAL alone could not predict renal progression; however, when serum and urine NGAL levels were combined, belonging to the high NGAL group independently predicted renal progression (hazard ratio [HR], 5.56; 95% confidence interval [CI], 1.42 to 21.73; p = 0.014), along with tubular damage graded according to the Oxford classification as T2 (HR, 8.79; 95% CI, 2.01 to 38.51; p = 0.004). In addition, a Kaplan-Meier curve of renal survival showed significantly higher renal progression in patients in the high NGAL group (log rank, p = 0.004).ConclusionsIn patients with IgAN, high serum and urine NGAL levels at the time of kidney biopsy predict renal progression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High serum and urine neutrophil gelatinaseassociated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy

Rhee

Shin

et al. 2015

Korean J Intern Med

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“…Most of the patients were treated according to the accepted standards at our center [12]. Long-term ACE-I or ARB treatment was recommended if there were no any contraindications.…”

Section: Methodsmentioning

confidence: 99%

“…Studies have reported that prednisone can reduce urinary protein, protect kidney function, and delay the progress of IgAN [9–11]. Kidney disease: improving global outcomes (KDIGO) clinical practice guideline for glomerulonephritis suggest that patients with persistent proteinuria >1 g/day, despite 3–6 months of optimized supportive care [including angiotensin converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) and blood pressure control], and GFR >50 mL/min per 1.73 m 2 , receive a 6-month course of corticosteroid therapy [12]. …”

Section: Introductionmentioning

confidence: 99%

Long-term kidney survival analyses in IgA nephropathy patients under steroids therapy: a case control study

Yuan

Wang

et al. 2015

J Transl Med

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BackgroundCorticosteroids are preferred to treat patients with active IgA nephropathy (IgAN), and beneficial effects from the short-term use of corticosteroids have been confirmed. However, a large number of patients will progress to end-stage renal disease after a long time follow-up. This study aimed to evaluate kidney disease progression and risk factors on kidney survival in IgAN patients receiving steroids treatment.MethodsTwo hundred biopsy-proven IgAN patients who received corticosteroid therapy were enrolled and followed for a median period of 63.33 months. Risk factors on kidney survival were retrospectively investigated by the Cox proportional hazards model.ResultsOf the two hundred patients, twenty patients showed progression of renal impairment at the end of follow-up. The median and interquartile range values for initial serum creatinine were 89.2 and 68.08–121.35 µmol/L, respectively. Multivariate Cox regression analyses revealed that relapse, non-remission, time-averaged eGFR (TA-eGFR), and time-averaged serum albumin (TA-ALB) were independently associated with the kidney progression. Those with TA-ALB levels <35 g/L and TA-eGFR levels <60 mL/min/1.73 m2 were less likely to recover from kidney progression. Patients were more likely to show kidney function deterioration, when they had non-remission or relapse after corticosteroids treatment.ConclusionThis study demonstrated that relapse, non-remission, TA-eGFR, and TA-ALB could serve as independent predictors of long term prognosis of IgAN patients receiving corticosteroid therapy.

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“…De hecho, las guías KDIGO de 2011 sugieren no tratar pacientes con NIgA con corticoesteroides combinados con ciclofosfamida o azatioprina, a menos que cursen con NIgAc y deterioro rápido de la función renal (recomendación 2D) 19 . La plasmaféresis ha sido usada en pacientes con NIgAc.…”

Section: Revisión De La Literaturaunclassified

Glomerulonefritis rápidamente progresiva asociada a ANCA en un paciente con nefropatía por IgA, reporte de caso

Wilches

Agudelo

Gómez

et al. 2017

Rev. Colomb. Nefrol.

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ResumenLa nefropatía por IgA es la glomerulonefritis más frecuente, en la cual menos del 10% de los pacientes cursan con deterioro rápido de la función renal. Los hallazgos histológicos de este grupo semejan los de vasculitis, con presencia de semilunas y necrosis fibrinoide. La coexistencia de nefropatía por IgA y anticuerpos anticitoplasma de neutrófilo es infrecuente y no está claro el rol patogénico de estos anticuerpos en la nefropatía por IgA. A continuación, se describe un caso de un paciente con nefropatía por IgA, glomerulonefritis rápidamente progresiva y anticuerpos anticitoplasma de neutrófilo positivos y se realiza una revisión de la literatura referente al tema.Palabras clave: nefropatía IgA, glomerulonefritis rápidamente progresiva, vasculitis, ANCA, semilunas. doi: http://dx.doi.org/10.22265/acnef.4.2.272 Abstract IgA nephropathy is the most common glomerulonephritis, in which less than 10% of patients have a rapid decline of renal function. The histological findings of this group resemble those of vasculitis, with presence of crescents and fibrinoid necrosis. The coexistence of IgA nephropathy and neutrophil anti-cytoplasmic antibodies is infrequent, and the pathogenic role of these antibodies in IgA nephropathy is unclear. Here we describe a case of a patient with IgA nephropathy, rapidly progressive glomerulonephritis and neutrophil positive anti-cytoplasmic antibodies, and literature review is presented.

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Chapter 10: Immunoglobulin A nephropathy

Cited by 103 publications

References 70 publications

High serum and urine neutrophil gelatinaseassociated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy

High serum and urine neutrophil gelatinaseassociated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy

Long-term kidney survival analyses in IgA nephropathy patients under steroids therapy: a case control study

Glomerulonefritis rápidamente progresiva asociada a ANCA en un paciente con nefropatía por IgA, reporte de caso

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